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Registration form

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Personal information
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Date of birth
 
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Name and telephone number of person
to contact in case of emergency
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Registration for the programme
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Invoicing details
The invoice should be :
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Company invoice address
Private invoice address
Invoicing details: SPLIT invoices
The first invoice should be sent to:
Company invoice address (split invoices)
pick a value between 1-99 if you need 2 invoices. Fill out 100 if you only need 1 invoice
Private invoice address (split invoices)
pick a value between 1-99 if you need 2 invoices. Fill out 100 if you only need 1 invoice
Invoicing details: SPLIT invoices
The SECOND invoice should be sent to:
Company invoice address for 2nd invoice (split invoices)
pick a value between 0-100.
Private invoice address for 2nd invoice (split invoices)
pick a value between 0-100.
Instalments

Please tick in case you want to pay in 4 instalments. This option is only possible for the part paid by a private person. A fee of 250 EUR and a signed contract is required in case of payment in instalments

I wish to pay in 4 instalments
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Commitment fee payment

Full-time MBA – Brussels

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